An increased awareness of sickle cell disease in the black community has developed in recent years. Consequently, many screening programs to detect this disease and the trait have been instituted. Numerous anecdotal reports dealing with apparent malignant medical consequences of sickle cell trait have appeared. Nevertheless, except for hematuria, well-documented adverse clinical effects have been observed only under unusual stressful circumstances and cannot be considered an important threat to most sickle cell trait carriers.1 The information to be gained by the detection of carriers in screening programs is, therefore, usually not clinically relevant to the carrier who is identified. Its main value would have to be in genetic counseling.

Clearly, the impact of any screening program must depend ultimately on the information available to the medical profession. This is true especially for those individuals directly involved in screening programs and providing medical and genetic information to people with positive